High-Performing Health SystemTM Triple Aim Efficiency Population Health AMGA Foundation Acclaim Award 2018 Application Quality Measurement and Improvement Care Coordination Evidence-based Medicine Patient Experience Accountability Health Information Technology
Important Dates May 9, 2017 May 16, 2017 September 22, 2017 December 18-22, 2017 March 7-10, 2018 Applications available Orientation webinar Applications due Applicants notified of status of their Application Event honoring Acclaim Award recipients and honorees at AMGA s Annual Conference, Phoenix Convention Center, Phoenix, Arizona. 2
General Overview The AMGA Foundation welcomes your application for the Acclaim Award. The Acclaim Award is the Foundation s most prestigious quality award. Its mission is to honor the nation s premier healthcare delivery organizations that are highperforming and are bringing their organization closer to the ideal medical group and health system by: n Measurably improving the quality and value of care n Improving patient experience and outcomes n Continuously learning and innovating n Improving population health This Acclaim Award application has been modified so that applicant groups can describe significant, group-wide efforts to improve value. Who Is Eligible to Apply for the Acclaim Award? To apply for the Acclaim Award, your organization must be a current member of AMGA. The 2016 Acclaim Award Recipients are not eligible to apply for the 2018 Acclaim Award. How Many Organizations Will Be Awarded the Acclaim Award? There are two categories for consideration for the Recipient Award; one organization with more than 150 FTEs and one organization with fewer than 150 FTEs, as determined by AMGA dues status. The Review Committee will determine how many recipients and honorees will be awarded. What Will an Organization Receive If It Is Named a Recipient of the Acclaim Award or an Honoree? The award recipients will be presented with a Pelucida-designed crystal award designed exclusively for the Acclaim Award. The recipients will receive free registration, travel, and one-night hotel stay for up to five team members at AMGA s Annual Conference, taking place March 7-10, 2018, at the Phoenix Convention Center. Honorees will receive free registration, travel, and one-night hotel stay for up to three team members at the Annual Conference. Recipients and honorees will be recognized at an awards ceremony and reception at the Annual Conference and must agree to attend. Expectations of Acclaim Award Recipients and Honorees The recipients and honorees will have the opportunity to: n Publish stories of their award-winning initiatives in AMGA s Group Practice Journal; n Participate in an educational session during the AMGA Annual Conference (for recipients only); n Receive a marketing packet to assist with promotion; and n Participate in educational webinars and meetings to further share their best practices. 3
AMGA High-Performing Health System Attributes The Acclaim Award uses the AMGA High-Performing Health System attributes as the standard for reviewing candidates for the award and we suggest that you thoroughly understand these attributes and incorporate them into your application. Efficient Provision of Services The provider entity successfully manages the per capita cost of health care, and improves the overall patient care experience and the health of their respective populations. Organized System of Care The provider entity includes a multispecialty medical group or other organized system of care and: n Provides a continuum of care, including prevention and ambulatory care, for a population of patients; n Is integrated or has partnerships with other care sites, which may include, but not be limited to, acute care hospitals, long-term acute care hospitals, inpatient rehabilitation facilities, skilled nursing facilities, home health agencies, ambulatory surgery centers, and hospices to provide the appropriate care setting for each patient s needs; n Includes physicians who are the principal leaders of all clinical programs and medical care and share responsibilities for the non-clinical aspects of governance, administration, and management; and n Assumes accountability for coordination across transitions in care. Quality Measurement and Improvement Activities The provider entity conducts quality measurement and improvement activities across sites of care and between patient visits to improve the health and outcomes of populations, including: n Preventive care and chronic disease management for targeted groups of patients; n Ongoing patient outreach programs, such as patient registries, to improve the health of those populations; n Participation in continuous learning, such as collaboratives, and the conduct of benchmarking on utilization rates and patient outcomes with other peer groups; n Use of research and/or other mechanisms, such as applied data analytics, to validate clinical process and outcomes data to determine effectiveness; n External reporting and transparent internal reporting on clinical outcomes, variability, and timely performance improvements; and n The conduct of patient experience surveys, which would be made publicly available. 4
Care Coordination The provider entity uses a team-based approach that supports collaboration and communication among the patient, physician, and licensed or certified medical professionals who are working at the top of their field across medical specialties and healthcare settings to improve the patient s well-being. This activity shall include: n A single plan of care across health care settings and across healthcare providers who furnish care to the patient; and n Shared decision-making, which is a collaboration between the patient and healthcare provider that empowers the patient in the decision-making process; and provides the patient with objective information concerning: (1) the risk or seriousness of the disease or condition to be prevented or treated; (2) available treatment alternatives; and (3) the costs and benefits of available treatment alternatives. Use of Information Technology and Evidence-based Medicine The provider entity meaningfully uses interoperable information technology, scientific evidence, and comparative analytics to: n Aid in clinical decision making and improve patient safety n Help monitor patients and track preventive services n Aid in the prescribing of prescription drugs. Compensation Practices That Promote the Above-Listed Objectives The provider entity uses compensation structures that provide incentives to physicians and licensed and certified medical professionals to improve the health and outcomes of populations. These compensation practices may include, but not be limited to, incentives that are affiliated with: n Patient experience; or n Quality metrics, such as chronic disease measures and prevention compliance within a physician s managed population. Accountability The provider entity assumes shared financial and regulatory responsibility and accountability for successfully managing the per capita cost of health care, improving the overall patient experience, and improving the health of their respective population. 5
The Application 1. Describe your organization, including its history, size, governance, corporate structure, management, payment models, and other key organizational attributes that describe the present organization at this stage of its development. Please make special reference to any special or underserved populations that your organization serves with quantification, if possible. (Suggest <600 words) 2. Describe how your organization is transforming health care in order to more fully achieve the AMGA High-Performing Health System attributes, improving both the quality and cost of care. (Suggest no more than SIX (6) pages) Please provide a specific example of how your organization was able to implement each attribute. AMGA HPHS Attributes n Accountability n Care Coordination n Compensation Practices That Promote the Above-Listed Objectives n Efficient Provision of Services n Organized System of Care n Quality Measurement and Improvement Activities n Use of Information Technology and Evidence-based Medicine 3. Provide detailed narratives describing the design and deployment of major improvement initiatives that moved your organization along the path of High-Performing Health System TM. (Suggest each narrative should be no more than FOUR (4) pages or TWELVE (12) pages in total). Each narrative should include a minimum of the following elements: n The design process; n The deployment process including processes, staff roles, training, and engagement; n Any changes in the way that care is organized and provided to patients and families; n Goals, measures, and matrixes related to that aspect of your plan(s); n Obstacles anticipated and unanticipated; and n Important learnings during this aspect of your larger plan, etc. 6
Guidelines for Submission To apply for the AMGA Foundation Acclaim Award, your organization must be a current member of AMGA. Applications are due by close of business (5:30 pm PDT), September 22, 2017. 1. Applications will be evaluated in a blinded review process. Remove all patient, provider, and clinic identifiers from the application (including any supporting documentation, appendices, etc.), except for the cover sheet (see below). n Refer to people by title (not name). n Refer to your organization using words like medical group or organization (recommend using the Word search-and-replace function to make sure your organization name and acronym do not appear in the document). n If you need to reference your city or state, use words like city, area, region, or state instead of the actual name. n Remove all clinic identifiers (including logos) from any supporting documents. 2. Provide a separate Cover Sheet with: n Application Title n Organization n Primary Contact Information (name, title, e-mail, phone, address) n Sponsor Signature (CEO or medical director) and Contact Information (name, title, email, phone, address) 3. Submit one electronic copy of the application to acclaim@amga.org by close of business (5:30 pm PDT), September 22, 2017. n Send the cover sheet as a separate file named Cover Sheet. n The application and any supporting documents (when possible/applicable) should be in one electronic document named Application. Please submit these items in a Word document. n If you need to send the supporting documents as separate attachments, name them Appendix 1, Appendix 2, etc. There are no page restrictions for the appendices; however, appendices should only include tables, graphs, or figures and not additional text. Application Specifications n The application, cover sheet, and all supporting documents/appendices, must be submitted in Microsoft Word or Excel documents. n The text of the application must not exceed nineteen (19), single-spaced pages. n Font: Calibri, 11 or 12 point. n Margins: 1inch top/bottom and left/right. n There are no page restrictions for the appendices; however, appendices should only include tables, graphs, or figures and not additional text. Questions: Contact Danielle Casanova at 703.838.0033 ext. 347 or dcasanova@amga.org 7
Evaluation Criteria Applications will be evaluated with respect to: 1. The extent to which your organizational mission, strategic goals, and actions support AMGA s definition of a High-Performing Health System 20% 2. How effective your leadership was in articulating the vision, and how effective your teams were in carrying out the vision 20% 3. How your organization promoted innovation and learning 15% 4. The impact of your actions on the populations you serve 30% 5. Replicability of the actions taken and the results 10% 6. Readability of the application 5% Cover Sheet Contact Information Sponsoring Leader Signature Checklist Clinic and Patient Identifiers (i.e., logo, clinic name, and clinic city/state) removed from the body of the Application and supporting documents Application (total no more than 19 pages) Supporting Documents (highly recommended if applicable; data only and unlimited number of pages) Submit an Electronic Copy to acclaim@amga.org by 5:30 pm PDT, September 22, 2017 8
Acclaim Award Application Toolkit Suggestions for Your Application Your application should include the following information: Strategy: What is your overarching strategy and what goals have you set in planning your organization s efforts to improve the value of care? How do you/how will you measure success or failure? Clearly defining your goals and the strategy intended to accomplish them is important. The Acclaim Award is not limited to those who attempt to accomplish complete system reorganization or turnaround. It is for those who set clear goals and successfully work to meet them. Clearly delineate the boundaries of your efforts. Timeframe: It is helpful if you identify the planned or anticipated timeframe for your strategy, including the start day, key benchmarks and their deadlines, etc. If the strategy has been updated or changed, explain how, why, and when those changes occurred. It is not necessary for a strategy to have been completed to apply for the Acclaim Award, but higher rated applications typically have demonstrated accomplishments beyond the planning stage. High Performing Health System (HPHS) Attributes: As mentioned above, the Acclaim Award is premised on the values of the Triple Aim, the IOM Aims for Healthcare, and the AMGA High-Performing Health System (HPHS) attributes. Of these, the HPHS attributes are the criteria that most guide our consideration of applications. We encourage you to mention any aspects of your organization s vision or work that are particularly rooted in the Triple Aim or IOM Aims, but applications should demonstrate a thorough consideration of the HPHS criteria. It is not necessary that your application include a checklist for each attribute of HPHS, but your application should reflect the organization s progress towards achieving the criteria. Tactical or Project Plans: Applicant groups may have many tactical plans, some running concurrently and others sequentially, in order to meet their strategic or overall goals. Descriptions of two key tactical (or phase or project) plans that describe what specific changes are being or will be undertaken to change the ways that care is delivered should be included. It will give the reviewers a more detailed view of your improvement methods. A description of the goals set for each tactical plan is very helpful. It is expected that your tactical plans will collectively align with your strategic plans. Samples of Results: It is important to demonstrate results over time. Increasingly, we use the results achieved as a significant variable in comparing applicant organizations and selecting an Acclaim Award recipient. It is beneficial to include data that shows overall improvement, including quality measures, patient experience measures, efficiency measures, and provider satisfaction results. Also, if there are any benchmarks to which you can compare your results, those benchmarks are also very helpful. See Reporting Results. Reporting Results 1. Focus on the most important measures related to organizational performance and to your initiatives. 2. Reported measures should have been covered or referred to in the body of the application. 3. When reporting outcome and process measures, make sure that: A. Performance levels you report are displayed on a scale that will be meaningful to our evaluators; B. You show trends so that we can see (a) the direction of performance, (b) timeframes, (c) rates of change, and (d) when deployments occurred; and C. You explain significant changes, upward or downward, in the body of the application. 9
4. Whenever possible, provide comparison results to national, regional, specialty, or other benchmarks so we can see how your results compare against other, appropriately selected organizations. 5. Some results may need to be normalized to allow meaningful comparisons. For example, needle sticks per patient days is more meaningful than an absolute number of needle sticks. 6. Less chart ink is better. Consider line charts (plotting data over time) over bar and pie charts. Make sure the charts are clearly annotated. 7. You may include results, graphs, or tables in the body of your application, but they do count as part of the page limit. You may also include results, graphs, or tables in separate appendices (no page limit). Examples of good data reports: CRC HEDIS Performance 2004 2012 Percentage of Pneumonia Patients Following Protocol Hosp A Hosp B Hosp C Best Practice Percent Compliance 100% 75% 50% 25% 0% 2008 2009 2010 2011 2012 2013 Sample Timeline Below is a sample timeline used by a past recipient when preparing their Acclaim Award application: AMGA Acclaim Award - sample application timeline 4 months 3 months 2-3 months 2 months Identify sponsors, workgroup, and key themes/topics to highlight Attend Acclaim Award Orientation Webinar Notify stakeholders Build outline of application, examples Develop effective visual aids Distribute first rough draft to sponsors and full workgroup 1.5 months 1 month 2 weeks Due Date Distribute edited draft Final draft to workgroup and sponsors Final draft to organization executive leaders Submit and celebrate! 10
Acclaim Award Recipients Allina Medical Clinic Cornerstone Health Care, PA The Everett Clinic Geisinger Health System Group Health Physicians HealthPartners Henry Ford Medical Group Mayo Clinic Health System Midelfort Clinic Mercy Clinics, Inc. Mount Carmel New West Physicians, PC Park Nicollet Health Services Premier Medical Associates The Permanente Medical Group The Salem Clinic, PC Sharp Rees-Stealy Medical Group Acclaim Award Honorees Allina Medical Clinic Aurora Health Care Carle Clinic/Health Alliance Medical Plans Carolinas Physicians Network The Cleveland Clinic Foundation Dreyer Medical Clinic Edmonds Family Medicine Clinic Gould Medical Group HealthCare Partners HealthTexas Provider Network Henry Ford Health System Johns Hopkins Medicine Lovelace Health Systems Mayo Clinic Health System Decorah Clinic Mayo Clinic Health System Lake City Clinic Mayo Clinic Health System Midelfort Clinic Mayo Clinic Health System Owatonna Clinic Mayo Clinic Health System Red Cedar Mercy (St. John s Health System) Mercy Clinics, Inc. Mid-Atlantic Permanente Medical Group NorthShore University HealthSystem North Texas Specialty Physicians Northwest Permanente Medical Group Ochsner Health System Park Nicollet Health Services Providence Medical Group Reliant Medical Group (Fallon Clinic) Sharp Rees-Stealy Medical Group Southeast Permanente Group (Kaiser Permanente Georgia) ThedaCare Physicians TriHealth UPMC Susquehanna Health University of Pennsylvania Health System Virginia Mason Medical Center Wellmont Medical Associates WESTMED Medical Group Wilmington Health, PLLC At Premier Medical Associates, we believe that making progress towards value-based care is a moral imperative. We are eternally grateful to AMGA for developing a road map to assist us all on the journey toward the Triple Aim. We are humbled to be recipients of the Acclaim Award and it only serves to inspire us more to collaborate with and learn from our colleagues to raise the quality and lower the cost of the care we provide to our communities. Mark De Rubeis, M.B.A., Chief Executive Officer Premier Medical Associates 2016 Acclaim Award Recipient One Prince Street, Alexandria, VA 22314-3318 amga.org/foundation